Thank you for registering your child for school at Oseh Shalom.

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Are you currently a member of Oseh Shalom?

YesNoNot SureInterested in Exploring

How Many Students are you registering?

Parents' Information

First Name

Last Name

Email Address

Parent 2 First Name

Parent 2 Last Name

Parent 2 Email Address

Address

City

State

Zip Code

County

Home Phone

Primary Contact Phone Number

Is Parent 2 at the same address as Primary Contact?

YesNo

Parent 2 Address

Parent 2 City

Parent 2 State

Parent 2 Zip Code

Parent 2 County

Parent 2 Phone Contact Number

Family Directory Permission

Consent to Appear in Religious School Family Directory
YesNo

Is there any information you would like not to be included in the directory?

Photo Publishing Permission

Yes, I give permission for my child’s photo to be used in the Oseh newsletter, the Oseh website, etc.No, I understand that in order to opt out I will need to email the Director at EducationDirector@oseh-shalom.org

Emergency Medical Information for My Children

(If children have different information, that can be captured for each child in the next section.)

Medical Insurance

YesNo

Medical Insurance Company

Policy Number

Student's Doctor

Doctor's Phone Number

Emergency Medical Consent

YesNoI hereby give consent for (1) administration of emergency medical treatment, and (2) the transfer of my child to a nearby hospital. Facts concerning my child's medical history including allergies, medications being taken and physical impairment to which a medical specialist should be alerted are listed below.

Emergency Contact Information

Name of Emergency Contact #1

Phone of Emergency Contact #1

Email of Emergency Contact #1

Relationship to Student

Name of Emergency Contact #2

Phone of Emergency Contact #2

Email of Emergency Contact #2

Relationship to Student

I understand a $300 family deposit received on or before June 30th will result in the early bird discount.

Yes, I understand that attendance at family programs and family services is an integral part of my child/children's education.

Total

Religious School Registration 2025 - 2026

Thank you for registering your child for school at Oseh Shalom.

YOU ARE NOT LOGGED INTO YOUR SHULCLOUD ACCOUNT If you are new, please continue without logging in. Families with a ShulCloud Account should log into their ShulCloud Account to pre-fill the form. If your name, address and email are not filled in below, you are not logged in.

Are you currently a member of Oseh Shalom?

How did you originally find out about Oseh Shalom/Oseh Shalom Religious School?

How Many Students are you registering?

Parents' Information

First Name

Last Name

Email Address

Parent 2 First Name

Parent 2 Last Name

Parent 2 Email Address

Address

City

State

Zip Code

County

Home Phone

Primary Contact Phone Number

Is Parent 2 at the same address as Primary Contact?

Parent 2 Address

Parent 2 City

Parent 2 State

Parent 2 Zip Code

Parent 2 County

Parent 2 Phone Contact Number

Family Directory Permission

Consent to Appear in Religious School Family DirectoryYesNo

Is there any information you would like not to be included in the directory?

Photo Publishing Permission

Emergency Medical Information for My Children

(If children have different information, that can be captured for each child in the next section.)

Medical Insurance

Medical Insurance Company

Policy Number

Student's Doctor

Doctor's Phone Number

Emergency Medical Consent

Emergency Contact Information

Name of Emergency Contact #1

Phone of Emergency Contact #1

Email of Emergency Contact #1

Relationship to Student

Name of Emergency Contact #2

Phone of Emergency Contact #2

Email of Emergency Contact #2

Relationship to Student

Student Information

Student First Name

Student Last Name

Student Hebrew Name

Student Email Address (for Madrichim Only - Optional)

Who is Student Living with

Who is Student living with?

Additional Emergency Medical Information

Emergency Information Above Applies to this Student

Changes to Medical Info for this Student

Emergency Contact Information Above Applies to this Student

Emergency Contact Information

Student's Birth Date

Was the student born before or after sundown (used to calculate Hebrew Birthday)

Grade and Class Selection

Secular Grade in Fall 2025

Secular School in Fall 2025

Oseh Shalom Lower School Grade in Fall 2025

Oseh Shalom Upper School Students' Grade in Fall 2025

Oseh Shalom Upper School Choices

Note- 8th-12th Graders May Choose up to Three Options. (Teen programming meets on alternate days/times.) Check All that Apply:

Teen Connect

Teen Connect

Doing Jewish-Confirmation (for All Teens)

Doing Jewish-Confirmation (for All Teens)

Madrichim Program (Teen Classroom Assistants)

Allergies and Medications

Allergies for this Student

Relevent Medications for this Student

Special Services Information/Education Plan

Does your child receive services under a 504 plan, an IEP or other formal education plan?

Please bring the educational plan with you on the first day to give to the Education Director.

YOU ARE NOT LOGGED INTO YOUR SHULCLOUD ACCOUNT
If you are new, please continue without logging in.
Families with a ShulCloud Account should log into their
ShulCloud Account to pre-fill the form.
If your name, address and email are not filled in below, you are not logged in.

Consent to Appear in Religious School Family Directory
YesNo

Note- 8th-12th Graders May Choose up to Three Options. (Teen programming meets on alternate days/times.)
Check All that Apply: